Bariatric Surgery May Harm Marital and Family Relationships

New research findings suggest for some, being married might actually work against patients’ quest to keep weight off, say investigators from Ohio State University.

The researchers, led by Megan Ferriby, a graduate student in human sciences, concluded that the impact of weight-loss surgery extends to his or her romantic relationships and likely to the entire family.

The Ohio State team reviewed 13 studies on weight-loss surgery and found that, in some cases, married patients lost less weight than their single peers. They also discovered evidence that a married couple’s relationship could deteriorate post-surgery. Their work appeared in the journal Obesity Surgery.

Sharing meals appears to play a vital role in the family culture.

“Food is so central to family routines and celebrations and when you undergo a surgery that so vastly impacts your ability to eat as you did before, family members take notice,” Ferriby said.

She and Dr. Keeley Pratt, Ferriby’s adviser and assistant professor of human sciences, said that what they found in this study has propelled them to look more closely at the role of romantic and family relationships.

Surprisingly, researchers discovered spouses and other family members are often not involved in the determination to have surgery.

The investigators believe inclusion of spouses and other family members in the conversations before and after surgery can help the patient have the best chance of reaching his or her goal weight and maintaining that weight loss.

Weight-loss surgery is often associated with marriage as about 65 percent of people seeking weight-loss surgery share a common bond. Ideally, health care teams could capitalize on the potentially positive influence of supportive and engaged spouses, the researchers said.

In cases where a spouse is not supportive, the health care team could work to strengthen the relationship and boost spousal support prior to surgery.

The researchers want to examine the issue more closely and are doing so in two studies with patients seen at Ohio State’s Wexner Medical Center.

They are collecting more data to better understand the impact of surgery on romantic and family relationships and how those relationships contribute to weight-loss success, Pratt said.

The recently completed review included studies published between 1990 and 2014. The Ohio State researchers divided those efforts into two categories. First off, they looked at research on the influence of marriage on weight loss after surgery. Secondly, they examined the effects of surgery on the quality of the marital relationship.

Several surgical options are now available to obese patients. Most of those in the studies reviewed by the Ohio State team underwent gastric bypass, in which surgeons create a smaller stomach and bypass part of the digestive tract. Other approaches include just reducing the stomach size and placing a band on the stomach.

Four of six studies that addressed marriage and weight loss showed that the patients who were married lost less weight.

One of the studies, which looked at 180 gastric-bypass patients, showed that married surgical patients were 2.6 times more likely to have not reached their goal weight a year after surgery. Another study showed unmarried patients were 2.7 times more likely to stick with post-surgical diet and exercise goals.

The other two studies in the category showed no connection between marital status and amount lost. None of the studies showed better weight loss for married patients.

When the researchers looked at data on relationship quality in 10 studies, they found evidence that some patients’ marriages appeared to deteriorate after surgery. One study found husbands grew more dissatisfied after wives’ surgery, especially if the wife became more assertive.

Though relationship quality took a hit in some of the studies, three that addressed sexuality pointed to more sex and more enjoyment of sex.

The researchers said the results illustrate the importance of working with the patient’s family throughout the surgery process.

Shifting behaviors and routines in a family can be unsettling, whether to spouses, partners, or children, said Pratt, who also works with pediatric weight-loss patients and their families.

Hospitals that offer weight-loss surgery have increasingly focused on pre-surgical psychological preparation for their patients — and on techniques to help them not only lose weight but maintain healthy lifestyles.

However, little has been done to encourage family members, including spouses, to be part of the process so that they might better understand and support their loved ones, Pratt said.

Peer support is often available to surgical patients, but even though that can be helpful for the person who has undergone surgery, it could potentially make a spouse feel alienated, Ferriby said.

Because the studies the team reviewed included mostly white, middle- to upper-class female surgical patients who were heterosexual and married, future research into the relationship dynamics within a more diverse population is important, Ferriby said.

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‘Love Your Body’ to Lose Weight

Almost a quarter of men and women in England and over a third of adults in America are obese. (In South Africa statistics on the percentage of overweight and obese people indicate that obesity and its co-morbidities are on the increase, with Cape Town leading the way!) Obesity increases the risk of diabetes and heart disease and can significantly shorten a person's life expectancy. New research published by BioMed Central's open access journal International Journal of Behavioral Nutrition and Physical Activity shows that improving body image can enhance the effectiveness of weight loss programs based on diet and exercise.

Researchers from the Technical University of Lisbon and Bangor University enrolled overweight and obese women on a year-long weight loss program. Half the women were given general health information about good nutrition, stress management, and the importance of looking after yourself. The other half attended 30 weekly group sessions (the intervention plan) where issues such as exercise, emotional eating, improving body image and the recognition of, and how to overcome, personal barriers to weight loss and lapses from the diet were discussed. On the behavioral intervention plan women found that the way they thought about their body improved and that concerns about body shape and size were reduced. Compared to the control group they were better able to self-regulate their eating and they lost much more weight, losing on average 7% of their starting weight compared to less than 2% for the control group. Dr Teixeira from Technical University of Lisbon, who led the research, said, "Body image problems are very common amongst overweight and obese people, often leading to comfort eating and more rigid eating patterns, and are obstacles to losing weight. Our results showed a strong correlation between improvements in body image, especially in reducing anxiety about other peoples' opinions, and positive changes in eating behavior. From this we believe that learning to relate to your body in healthier ways is an important aspect of maintaining weight loss and should be addressed in every weight control program."

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Also known as bariatric surgery, weight loss surgery constitutes a number of procedures all with one goal in mind being weight loss for the patient suffering from obesity. Along with this primary goal, other effects from such procedures are an improvement in cardiovascular functions and decrease in associated risk or even full recovery from diabetes. The procedures involved can either make use of specific apparatus or even altering of the digestive organs.

Rules for Successful Dieting

Follows five basic rules:

Rule One: Eat Your Target Protein Every Day

By consuming the minimum amount of protein for your body, you maintain energy, muscle mass, and keep your hunger in check.Rule Two: Take Your Supplements Every Day
The daily nutritional supplements we prescribe to you will have a positive effect on your long-term health, energy, and longevity. Rule Three: Drink Water Every Day
As your body burns calories, waste products are released through urine. Drinking at least 64 ounces of water daily helps release these waste products so they don’t build up and slow your metabolism.Rule Four: Continue an Exercise Program
Getting the right amount of exercise is an essential part of successful long-term weight control and total well-being. Rule Five: Be Consistent with Your Diet
If you stick to your daily eating prescription and keep your caloric intake consistent from day to day, you increase your chances of maintaining your optimal weightGet your Maintenance Diet Plan today contact our resident Dietitian:Judy Kotze - Dietitian Special interest: Bariatric Nutrition BSc (Dietetics) - Diploma in Hospital Dietetics M (Nutrition) Durbanville Medi-Clinic Tel: 27-21 975 2336 Fax 27-21 9752692 Mobile: 083 254 0919

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Key Lifestyle Changes with Weight Loss Surgery

Some of the most important lifestyle changes to adapt to after weight loss surgery include:

* Slowly increasing physical activity
* Assessing and logging in daily food intake
* Undergoing counseling to adapt to the changing body image
* Eliminating social situations that promote overeating
* Tackling any emotional issues that triggered overeating with a therapist
* Making time to prepare special foods and meals to complement a healthier lifestyle